Basic Information
| Provider Information | |||||||||
| NPI: | 1457383077 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MACHADO | ||||||||
| FirstName: | EUGENIO | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5525 RESEARCH PARK DR FL 4 | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212284873 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3015728340 | ||||||||
| FaxNumber: | 3015728403 | ||||||||
| Practice Location | |||||||||
| Address1: | 3110 GRACEFIELD RD | ||||||||
| Address2: | |||||||||
| City: | SILVER SPRING | ||||||||
| State: | MD | ||||||||
| PostalCode: | 209041820 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3015728340 | ||||||||
| FaxNumber: | 3015728403 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/06/2006 | ||||||||
| LastUpdateDate: | 12/09/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | D0024035 | MD | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 008203102 | 05 | MD | MEDICAID | 340040-20 | 01 | MD | BCBS OF MD | OTHER | 0039 | 01 | DC | BCBS OF DC | OTHER | 04-05771 | 01 | MD | EVERCARE | OTHER | 0943ER-340040-02 | 01 | CAREFIRST BCBS OF MD | OTHER | 34004002 | 01 | BCBS | OTHER | 0943SE-340040-02 | 01 | CAREFIRST BCBS OF MD | OTHER | 313841100 | 05 | MD | MEDICAID | 9680-0025 | 01 | CAREFIRST BCBS OF DC | OTHER |